A 29-year-old woman with two sons developed a rest tremor and motor slowness in her right limbs. She was diagnosed as Parkinson's disease (PD) and was treated with anti-cholinergic drugs. After three years of taking a dopamine agonist (cabergoline, 4 mg per day), she became pregnant. The patient and her husband decided to have an abortion because they worried that the cabergoline might have harmed the fetus. The patient hoped to prepare for future planned birth, so we canceled the cabergoline and gradually increased her carbidopa/levodopa dose. Her motor disability gradually worsened during the pregnancy, and she developed prominent bradykinesia while taking a high dose of carbidopa/levodopa (1,000 mg per day) and a continuous infusion of levodopa. A cesarean section was performed, and the patient gave birth to a healthy baby. After the delivery, she was treated with pramipexole (2 mg per day), and her bradykinesia decreased. The initial anti-PD medication schedule for fertile female PD patients should be carefully considered to lessen the harm to the fetus, especially during organogenesis. Motor disability may worsen during pregnancy, and appropriate childcare support should be prepared.
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